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The number and share of people without insurance grew in 2024, increasing for the first time since 2019, according to KFF's analysis of data from the American Community Survey (ACS). This issue brief describes trends in health coverage in 2024, examines the characteristics of the uninsured population , and summarizes the access and financial implications of not having coverage.
This brief summarizes recent and proposed actions by states related to access to state-funded health coverage and other services for immigrants and immigration enforcement activity during the 2025 and 2026 state legislative sessions.
To help states launch the Affordable Care Act (ACA) Medicaid expansion and efficiently enroll eligible individuals, CMS has offered states a series of facilitated enrollment options. These options include strategies, referred to as “fast track enrollment” in this issue brief, that allow states to enroll eligible individuals into coverage using data already available from their Supplemental Nutrition Assistance programs (SNAP) and/or their Medicaid or Children’s Health Insurance Program (CHIP) programs for children. This issue brief…
This brief provides insight into lessons learned from Medicaid and CHIP outreach and enrollment strategies that can help inform implementation of the Affordable Care Act (ACA) coverage expansions by profiling a successful enrollment assistance initiative among health centers in Utah. The brief is part of the "Getting Into Gear for 2014" series examining key implementation issues as states prepare for the ACA coverage expansions. Issue Brief (.pdf)
This issue brief identifies key lessons learned from how four states (Missouri, Ohio, New Mexico, Rhode Island) are connecting people leaving the criminal justice system to Medicaid coverage and services, with a focus on medication-assisted treatment (MAT) and supports for people with opioid use disorder. It builds on previous briefs that assessed state efforts to connect people involved in the justice system to Medicaid coverage. It is based on interviews conducted in late 2018 and…
As states unwind the Medicaid continuous enrollment provision, they must comply with federal renewal requirements, including the requirement to conduct ex parte, or automated renewals. This policy watch explains what ex parte renewals are, examines variation in ex parte renewal rates across states, and discusses current issues as well as actions states are taking to increase ex parte rates.
This analysis allocates the CBO’s estimated reduction in federal spending in the enacted reconciliation package across states based on KFF’s state-level data and where possible, prior modeling work; and shows the federal spending reductions relative to KFF’s projections of federal spending by state under current law.
On February 1, 2018, the Centers for Medicare and Medicaid Services (CMS) approved an amended extension of Indiana’s Healthy Indiana Program 2.0 (HIP 2.0) Section 1115 demonstration waiver. Indiana’s waiver initially implemented the ACA’s Medicaid expansion from February, 2015 through January, 2018 by modifying Indiana’s pre-ACA limited coverage expansion waiver (HIP 1.0). Unlike other states that implemented the ACA’s Medicaid expansion through a waiver, Indiana’s demonstration also changes the terms of coverage for non-expansion adults…
The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would…
This brief highlights how state eligibility policies for incarcerated individuals differ, based on a review of state statutes, regulations, Medicaid eligibility manuals and other Medicaid agency guidance publicly available online and Medicaid managed care contracts. Overall, state Medicaid eligibility policies for justice-involved individuals moving into and out of incarceration vary, and these policies affect if and when individuals may enroll in Medicaid and the scope of any resulting savings.
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